High Risk Suicidal Behavior in Veterans

NCT02462694 | Completed DMC

• 1 other identifier: GOO-09-073
• Study Type: interventional
• Target: 91
• Locations: 0 countries
• Sites: N/A

Brief Summary

Suicide is a pressing problem in the US military, with evidence of increased risk for suicide particularly among soldiers serving in Iraq and Afghanistan. To date, there are very few studies that empirically evaluate treatment efficacy to prevent suicide. One treatment that has been shown empirically to decrease suicidal behavior is Dialectical Behavioral Therapy (DBT), although these studies have been limited to patients with borderline personality disorder (BPD). The current proposal aims to examine the efficacy of DBT in reducing suicidal behavior more broadly in a diagnostically heterogeneous group of veterans with high risk suicidal behavior. One of the difficulties in doing research in suicide prevention is that serious suicidal behavior is a relatively rare event, and alone is not a satisfactory target for treatment studies. It is extremely important, therefore, to identify intermediate symptoms that are closely associated with high risk suicidal behaviors, as targets for treatment. One critical area our proposal addresses is validating new treatment models for suicide in veterans; DBT has been empirically validated to reduce suicidal behavior in individuals with BPD, but has not been tested more broadly to target suicidal behaviors. The second critical area which our proposal addresses is exploring new suicide risk assessment measures. While the investigators do not specifically propose to develop new screening tools, the investigators do propose to identify potentially important domains that specifically differentiate ill high risk suicide veterans from low risk. This information will be useful in future efforts to modify the DBT approach to be more effective for the broader diagnostic group of high risk suicidal veterans.

Conditions

Suicide

Outcome Measures

Primary Outcomes (1)

• Counting of suicidal events

  Utilizing the The Columbia Suicide Severity Rating Scale

  6 months

Study Arms (2)

Treatment as Usual

ACTIVE COMPARATOR

Treatment as usual (TAU): Standard psychological, psychopharmacology and case management services

Behavioral: Treatment As Usual

Dialectical Behavior Therapy

EXPERIMENTAL

Standard Dialectical Behavior Therapy (DBT): weekly individual sessions, skills training group and telephone coaching as needed

Behavioral: Dialectical Behavior Therapy

Interventions

Dialectical Behavior Therapy BEHAVIORAL

Dialectical Behavior Therapy is an empirically validated treatment approach emphasizing the role of emotion regulation in the treatment of suicidal and self-destructive behaviors in BPD

Dialectical Behavior Therapy

Treatment As Usual BEHAVIORAL

TAU for these subjects involves close tracking by the Suicide Prevention Coordinator and treatment by their individual team of clinicians. Additionally, a support group with psychoeducation about suicide prevention will be offered as part of TAU

Treatment as Usual

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Veterans between the ages of 18 and 65
• Able to give consent
• Recent admission to psychiatric inpatient unit (6B)

You may not qualify if:

• Lifetime or current diagnosis of schizophrenia or other psychotic disorder; current psychosis from affective disorder
• IQ\<80
• Current evidence or history of significant organic brain impairment, including stroke, CNS tumor, demyelinating disease, severe head trauma.

Sponsors & Collaborators

• Bronx Veterans Medical Research Foundation, Inc: lead

Related Publications (1)

• Goodman M, Banthin D, Blair NJ, Mascitelli KA, Wilsnack J, Chen J, Messenger JW, Perez-Rodriguez MM, Triebwasser J, Koenigsberg HW, Goetz RR, Hazlett EA, New AS. A Randomized Trial of Dialectical Behavior Therapy in High-Risk Suicidal Veterans. J Clin Psychiatry. 2016 Dec;77(12):e1591-e1600. doi: 10.4088/JCP.15m10235.

  PMID: 27780335 DERIVED

MeSH Terms

Conditions

Suicide

Interventions

Dialectical Behavior Therapy; Therapeutics

Condition Hierarchy (Ancestors)

Self-Injurious Behavior; Behavioral Symptoms; Behavior

Intervention Hierarchy (Ancestors)

Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Marianne Goodman, MD

  James J. Peters Veterans Affairs Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Marianne Goodman, MD

Study Record Dates

• First Submitted: June 2, 2015
• First Posted: June 4, 2015
• Study Start: April 1, 2010
• Primary Completion: July 1, 2017
• Study Completion: July 1, 2017
• Last Updated: January 18, 2018

Record last verified: 2018-01